Have you ever wondered when to apply heat or when to apply ice?  If you have, you’re not alone.  Even us health care providers will tell you differently. 

Who do you believe then? 

I say believe your body. 

Here is what I know about heat and ice.

1. Both are analgesics, meaning their application will help reduce pain. They do this by helping block the pain signal travelling to the tract of the brain. It’s a one-way tract and more intense sensory stimuli (pain versus cold) will find its way to the brain. 

2. If you have signs of inflammation heat is not the best option. 

SIGNS:

Pain at rest

Redness

Swelling

Warmth

Local tenderness (pain on touching the area) that gets worse the more you touch it

3. If you’ve had a recent trauma (within the past 48 hours, including whiplash injury, a fall, or blow to the body) ice would likely be the better option.

4. If you have an ache or pain but did not have any impact trauma (kind of feels like you’ve strained a muscle), heat may do the trick of getting the muscle to relax.

A QUICK TRUE STORY

A middle aged woman who was playing indoor soccer went to kick the soccer ball and her quadricep (front thigh muscle) went into spasm. Then she kept playing (I never said the woman was smart) but only kicking with her left leg,and the same thing happened to her left side. Now she wasn’t able to kick at all. Being a physiotherapist, this soccer player, (well OK I’ll admit it’s me), applied ice to her injury.  Ahh–Not a good idea!  The muscles rebelled and went into more spasms. Heat felt much better.

5. If one, heat or ice, isn’t working (making things feel worse) try the other.

6. Heat tends to work well at relaxing muscle pain (which is why it works well after IMS treatments or before manual therapy treatments) and ice tends to work well when there is joint irritation (which is why some people with arthritic pain prefer ice and why a chiropractor or physiotherapist may suggest ice after a treatment that involves manipulation). 

7.  Even temporary relief is better than nothing at all. 

8. Ice is a great anti-inflammatory agent that does not upset your stomach. Some research has shown that ice application immediately after an injury (I am talking impact or trauma such as a sprained/twisted ankle) will improve recovery as it helps to contain the inflammation. 

9. You should not apply ice directly to your skin (wrap it in a towel or wet towel). Frost bite can be painful as well!

10. Ice application can be 10-15 minutes every hour. Any more time on ice causes the opposite effect (you get increased blood flow to the injured area rather than reduced as the body tries to regulate itself).

11. Heat can be left on longer but be careful not to burn yourself. 

12. Heat and ice do not take the place of a proper assessment and treatment by a health care professional.  If your injured area is not getting better on a daily or weekly basis, see a physiotherapist. I have clients who wait months with an injury that is not getting better before coming in for treatment.  The less time you have with an injury, the fewer treaments you will need.

ANOTHER STORY

A former client phoned in the day she strained her back (just standing up after being bent over). I saw her the next day. She then phoned and cancelled the following appointment as her pain had dissapeared. I would have liked to have seen her, however, one more time to make sure  the muscles that were in spasm I had helped release were working properly again.

***Remember that exercise and muscle retraining are the missing components to preventing recurring injuries and making for a more complete recovery.

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